MINNEAPOLIS — Some health systems in Chicago, San Francisco and Cleveland are now charging patients for sending certain messages to doctors through online portals like MyChart.
While prescription refills, scheduling visits, and asking follow-up questions shortly after a visit would likely not result in a charge, sending a picture of a new rash, requesting a form be filled out or requesting a change in medication might.
In Minnesota, major hospital systems including Hennepin Healthcare, HealthPartners, M Health Fairview, Allina Health and Essentia Health report they don't charge for basic messaging services at this time. Yet patients should be aware that certain E-visits may cost you.
"We at Hennepin do not charge for messages that are direct communications between the patients and the providers," Hennepin Healthcare physician and chief health information officer Dr. Deepti Pandita said. "What we do charge for is certain visit types that could be sort of administered through the patient portal called E-visits."
Meanwhile HealthPartners says, "For E-visits that are unrelated to a recent visit or diagnosis, there may be corresponding charges." HealthPartners says patients are generally not charged for follow up questions, normal test results or requests for work and school forms.
Dr. Pandita says the reason some hospital systems are charging for certain messages is because of a surge in online messaging and telehealth over COVID. She says a Hennepin Healthcare doctor may get hundreds to thousands of messages per day without getting paid for overtime work.
"An average provider who practices full time could actually be answering messages for three to four hours after their work day is done," she said.
Still Dr. Pandita points out that doctors may be incentivized to respond to online messages and says this may not benefit many patients.
"This is not a good trend from the lens of health equity," she said. "MyChart or any patient portal is typically an English only medium for people who have access to Internet … We are really leaving out a huge volume of patients who don't have the patient portal access … Providers who are getting incentivized for certain message types will prefer those than the message types that are not being incentivized."
Cynthia Fisher is founder of Patient Rights Advocate, a Massachusetts nonprofit pushing for hospital price transparency nationwide.
"Over $50 for an e-mail, are you kidding? Patients fear, already, being overcharged by the hospitals," Fisher said. "These electronic health record charges are creating a barrier, preventing communications with their doctor about their health and wellbeing."
She says skipping a simple check-in could be even more costly if the medical issue turns out to be serious.
Patients may want to take advantage of hospital price check tools when available and pay attention to what's on each hospital bill as certain charges may be disputed.
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